title: Renal carcinoma relapse presenting as a peripheral nerve sheath tumor: A case report and brief review of the literature.
abstract: We report a rare case of renal carcinoma metastasis involving a lumbar nerve root. Metastases to nerve roots are rare occurrences, and to our knowledge, only six cases have been reported so far in the literature. The patient in this report presented with weakness in the right lower limb and intractable pain irradiating along the L5 dermatome. MRI findings revealed a right-sided L5 nerve root mass, suggestive of a schwannoma, involving the spinal ganglion and its extraforaminal region. Complete macroscopic resection of this mass was performed, and histopathologic analysis confirmed the lesion to be a metastasis of a renal clear cell carcinoma. Local radiotherapy was given and tyrosine kinase inhibitors administered. At 5 months, the patient was pain-free and his right limb weakness had completely resolved. A tumoral recurrence could be observed on the control MRI 5 months after surgery. This report presents the first case of a patient with a renal clear cell carcinoma metastasis to a L5 nerve root, as well as a brief review of previous cases of metastases to peripheral nerve roots.
authors.affiliation: Neurosurgical Division, Geneva University Hospitals, rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland. ivan.cabrilo@hcuge.ch
authors.forename: I
authors.initials: I
authors.lastname: Cabrilo
authors.forename: K
authors.initials: K
authors.lastname: Burkhardt
authors.forename: K
authors.initials: K
authors.lastname: Schaller
authors.forename: E
authors.initials: E
authors.lastname: Tessitore
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000473:pathology*; D000368:Aged; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D005727:Ganglia, Spinal / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000473:pathology*; D017116:Low Back Pain / Q000209:etiology; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D018317:Nerve Sheath Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D013126:Spinal Nerve Roots / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Carcinome rénal; Chirurgie; Metastasis; Métastase; Nerve root; Racine nerveuse; Renal cell carcinoma; Surgery